Method and system for medical treatment review

ABSTRACT

A method of medical treatment review. The method can include the steps of receiving patient data into a patient database in which the patient data at least includes a diagnosis of the patient and providing one or more treatment protocols for the patient for selection by a treating provider in which the treatment protocols are pre-approved for the patient diagnosis. The method can also include the steps of analyzing a selection of a treatment protocol by the treating provider and generating an authorization of the selected treatment protocol based on predefined criteria. Generating the authorization of the selected treatment protocol can include generating the authorization without any peer review if the selected protocol meets the predefined criteria or generating the authorization following peer review if the selected protocol does not meet the predefined criteria.

FIELD OF THE INVENTION

The subject matter herein relates to the field of medical treatments andmore particularly, to the field of approval for such medical treatments.

BACKGROUND OF THE INVENTION

Healthcare costs have exploded over the past several decades, and healthinsurers and government agencies have implemented procedures to minimizesuch expenses. For example, insurance companies typically reviewprocedures performed on patients by physicians and will normally onlypay for costs associated with approved treatments. Even so, this processhas not limited the increasing costs associated with healthcare in thiscountry. Moreover, current fee structures are skewed to favor moreexpensive treatment drugs. In particular, doctors are typically providedwith a small percentage of the cost of a treatment used on a patient,and this arrangement causes treating physicians to choose more expensivepharmaceuticals, as opposed to lower cost drugs that are just aseffective. As such, there is a need for a system and method thatimproves oversight of medical treatment.

SUMMARY OF THE INVENTION

A method of medical treatment review is described herein. The method caninclude the steps of receiving patient data into a patient database inwhich the patient data at least includes a diagnosis of the patient andproviding one or more treatment protocols for the patient for selectionby a treating provider. The treatment protocols can be pre-approved forthe patient diagnosis. The method can also include the steps ofanalyzing a selection of a treatment protocol by the treating providerand generating an authorization or a recommended authorization of theselected treatment protocol based on predefined criteria. As an example,generating an authorization of the selected treatment protocol caninclude generating the authorization without any peer review if theselected protocol meets the predefined criteria or generating theauthorization following peer review if the selected protocol does notmeet the predefined criteria.

The peer review can include establishing a relationship between thetreating provider and a treatment reviewer to determine whether togenerate an authorization for the selected treatment protocol. Thetreatment reviewer can be, for example, a specialist in the fieldassociated with the diagnosis of the patient and the provided treatmentprotocols. Moreover, the peer review can further include seeking inputfrom an authorized agent following the establishment of the relationshipbetween the treating provider and the treatment reviewer. The method canalso include the steps of informing the treating provider of a status ofthe authorization and informing a primary care agent of the selectedtreatment protocol and any details of a peer review if such a review wasconducted.

In another arrangement, the method can include the step of determiningwhether to apply a normalization fee for the selected treatmentprotocol. As an example, the normalization fee can be applied toincrease the amount of profit that the treating provider would realizefor the selected treatment protocol. As another example, thenormalization fee can be a flat rate fee to be paid to the treatingprovider per treatment session for the patient. The method may alsoinclude the step of adjusting the number of treatment protocolsavailable for selection by the treating provider if an initial selectedtreatment protocol was unsuccessful in treating the patient. Adjustingthe number of treatment protocols available for selection by thetreating provider can include eliminating from selection the initialselected treatment protocol that was unsuccessful in treating thepatient and any equivalent treatment protocols.

A system for medical treatment review is also described. The system caninclude a patient database that can receive patient data from a treatingprovider in which the patient data includes at least a diagnosis of adisease of a patient and can include a treatment protocol database thatis coupled to the patient database. The treatment protocol database canbe populated with one or more treatment protocols that can provideguidelines for treating patients with various diseases. The system canalso have a protocol approval module that is configured to receive thepatient data and a treatment protocol that is selected by the treatmentprovider. The protocol approval module can analyze the patient data andthe selected treatment protocol and can generate an automatic approvalor forward the selected treatment protocol and the patient data for apeer review process.

The system can also include a peer review workstation that is configuredto receive the selected treatment protocol and the patient data, therebyenabling a treatment reviewer to determine whether the selectedtreatment protocol should be authorized or recommended forauthorization. In addition, the protocol approval module can be furtherconfigured to selectively generate a normalization fee that can bedesigned to increase the profit realized by the treating provider forthe selected treatment protocol, which can offset the loss of revenuethat may occur when a less costly protocol is chosen. Further, theprotocol approval module can be configured to selectively adjust theoption of selecting certain treatment protocols from the treatmentprotocol database based on an initial unsuccessful treatment of thepatient.

Another method of treatment review by a treatment reviewer is presented.This method can include the steps of receiving patient data and aselected treatment protocol for a patient from a treating provider inwhich the selected treatment protocol is part of an approved listing oftreatment protocols and conducting a peer review of the patient data andthe selected treatment protocol. The peer review can be conducted by atreatment reviewer, who can be a specialist in the field, to determinewhether to approve the selected protocol in view of other unselectedtreatment protocols that are part of the approved listing of treatmentprotocols. Conducting the peer review at least includes performing anexchange of information between the treatment reviewer and the treatingprovider. The method can also include the step of providing results ofthe peer review to the treating provider.

In one arrangement, the peer review can be conducted only if theselected treatment protocol is not automatically approved based oncertain predefined criteria. The method can also include the steps ofinforming a primary care agent of the selected treatment protocol andany details of the peer review and selectively conducting an appellatereview of the peer review if the treating provider maintains theselection of the selected treatment protocol.

Yet another method of selecting a treatment protocol by a treatingprovider is presented here. This method can include the steps ofentering patient data into a patient database and selecting a treatmentprotocol from a list of pre-approved treatment protocols in which atreatment protocol can be pre-approved based on the patient data. Themethod can also include the step of receiving an authorization for theselected treatment protocol in which the authorization or recommendationof authorization can be automatically generated or generated following apeer review that determines that other unselected treatment protocolsare unsuitable for the patient.

The method can also include the step of receiving a normalization feefor the selected treatment protocol based on predefined criteria inwhich the normalization fee can be a flat rate that can be received fortreatment sessions for the patient and can be higher than the amount ofprofit that the treating provider would receive based on a percentagefee of the selected treatment protocol. The normalization fee can bedesigned to eliminate the incentive to choose one protocol over anotherbased on the profitability of the protocol. When a normalization fee isapplied to less profitable protocols, the profitability of all protocolsin the group can be similar.

In one embodiment, the patient can be an existing patient, and thenumber of treatment protocols that are available for selection isdifferent than the number of treatment protocols that were available forselection at the initial entry of the patient data. This arrangement isbased on the understanding that patients who fail to respond to atreatment protocol or who relapse after receiving a treatment protocolare unlikely to respond to similar protocols in the future. Byeliminating from the group of available treatment protocols thoseprotocols that are very likely to be ineffective, the system minimizesthe probability that patients will be treated with ineffectiveprotocols.

Additional aspects will be set forth in the description which follows,and in part will be obvious from the description, or may be learned bypractice of the embodiment. The aspects will be realized and attained bymeans of the elements and combinations particularly pointed out in theappended claims. It is to be understood that both the foregoing generaldescription and the following detailed description are exemplary andexplanatory only and are not restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

Several embodiments are shown in the drawings. It is expressly noted,however, that the subject matter herein is not necessarily limited tothe arrangements and instrumentalities shown in the drawings.

FIG. 1 is an illustration of an exemplary system for medical treatmentreview; and

FIG. 2 is an illustration of an exemplary method for medical treatmentreview.

DETAILED DESCRIPTION

As noted earlier, healthcare costs in this country continue toskyrocket, and solutions are needed to get such expenses under control.As such, a method of medical treatment review that streamlines andmaximizes efficiencies in patient treatments while simultaneouslyassuring that patients are treated according to nationally recognizedguidelines is described below. The method can include the steps ofreceiving patient data into a patient database in which the patient dataat least includes a diagnosis of the patient and providing one or moretreatment protocols for the patient for selection by a treating providerin which the treatment protocols are pre-approved for the patientdiagnosis. The method can also include the steps of analyzing aselection of a treatment protocol by the treating provider andgenerating an authorization of the selected treatment protocol based onpredefined criteria. As an example, generating the authorization of theselected treatment protocol can include generating the authorizationwithout any peer review if the selected protocol meets the predefinedcriteria or generating the authorization following peer review if theselected protocol does not meet the predefined criteria. This processprovides a review of pre-approved treatments to ensure that the mosteconomical and/or appropriate protocol is selected by the treatingprovider without affecting the efficacy of the strategy developed totreat the patient.

The terms “a” or “an,” as used herein, are defined as one or more thanone. The term “plurality,” as used herein, is defined as two or morethan two. The term “another,” as used herein, is defined as at least asecond or more. The terms “including” and/or “having,” as used herein,are defined as comprising (i.e., open language). The term “coupled” asused herein is defined as connected, although not necessarily directly,and not necessarily mechanically. That is, “coupled” may also includetwo or more components that are wirelessly connected together.

The term “patient” is defined as any living thing that requires or mayrequire medical attention and includes human beings and animals. Theterm “patient data” means any information that is associated with apatient and that is used to select a treatment for that patient. A“treatment protocol” means any plan for treating a particular disease ormedical condition that has been pre-approved by an organization that isrecognized by the medical community for providing guidelines or advicefor such disease or condition. The term “diagnosis” means theidentification of a disease or medical condition of a patient that mayrequire treatment. The term “treating provider” means any person whoprovides medical treatment to a patient and may include persons notnecessarily licensed to provide such treatment. A “patient database” isdefined as any component or group of components configured to receiveand store information that is associated with a patient. Moreover, a“treatment protocol database” means any component or group of componentsconfigured to store any number of treatment protocols that may beselected by a treatment provider. The terms “approve(d)” or“authorize(d)” are defined as express approvals or authorizations by afirst party for a course of action or merely a recommendation for asecond party to approve or authorize a course of action.

Referring to FIG. 1, an example of a system 100 for medical treatmentreview is shown. In one arrangement, the system 100 can include apatient database 110, a treatment protocol database 120 that can becoupled to the patient database 110 and a protocol approval module 130.Although the protocol approval module 130 is shown as being a separatecomponent in FIG. 1, the subject matter described herein is not solimited, as the module 130 may be part of the treatment protocoldatabase 120 or even the patient database 110. The system 100 may alsoinclude a peer review workstation 140, which may also be coupled to theprotocol approval module 130. Each of these components may be linkedtogether through any suitable network, including wired or wirelessconnections.

As an example, the patient database 110 can store any suitable type ofinformation that is associated with a patient being treated by atreating provider. This information may be entered into the patientdatabase 110 by the treating provider or any other authorizedindividual. Examples of such information include the patient's sex,height and weight, blood type, age, allergies or any diagnoses and othermedical conditions and the extent of any diagnosis or medical condition.The treating provider may be, for example, a physician, a veterinarian,a nurse, or a paramedic or any other individual capable of providingsome form of medical care. In some circumstances, the patient and thetreating provider may be the same individual. To comply with privacyconcerns, the patient database 110 may be a secure database in whichonly a treating provider who is authorized by the patient may access thepatient's information contained in the patient database 110. Thistreating provider may have access to information in the patient database110 that is associated with all the patients for whom the provider isresponsible. Additionally, multiple treating providers may be able toenter patient data associated with their patients into the patientdatabase 110 and later access such information.

In one arrangement, the treatment protocol database 120 may contain oneor more treatment protocols for various diseases and medical conditions.These treatment protocols can typically include guidelines and advicefor treating such ailments and can be designed by, for example,organizations that are recognized by the medical community. As anexample, one or more of the treatment protocols may be plans fortreating a patient with cancer that are in accordance with theguidelines of the National Comprehensive Cancer Network or some othersuitable organization. As will be explained in more detail below, thesetreatment protocols may be pre-approved for treatment of a particulardisease or medical condition. The treating provider may then select atleast one of the treatment protocols from the list of pre-approvedtreatment protocols contained in the treatment protocol database 120. Itis understood that the number of pre-approved treatment protocols may beadjusted based on, for example, new discoveries or scientific studies.

The protocol approval module 130 may receive the patient data and theselected treatment protocol and may be configured to perform an analysisof this information. To perform such an analysis, the approval module130 may include any suitable combination of software and hardware,including processors and/or logic circuitry. Following the analysis, theprotocol approval module 130 may automatically approve or authorize theselected treatment protocol and can inform the treatment provider andother authorized individuals of such approval or authorization. Inanother arrangement, the protocol approval module 130, following theanalysis, may forward the selected treatment protocol and the patientdata to the peer review workstation 140 for a peer review process.

The peer review workstation 140 may include any suitable type ofhardware and software components to enable a treatment reviewer toperform a peer review process, such as conducting a review of thepatient data and selected treatment protocol. The treatment reviewer canalso have access to all the treatment protocols that are part of thetreatment protocol database 130. The peer review workstation 140 mayalso include any suitable means of communications to enable thetreatment reviewer to communicate with various authorized partiesregarding the peer review process.

Referring to FIG. 2, an example of a method 200 of treatment review isillustrated. When describing this method, reference may be made to FIG.1, although it is understood that the method 200 may be practiced inother suitable systems. It must be noted that the described method 200is not necessarily limited to these particular steps, as the method 200may contain a greater or fewer number of steps in comparison to what ispictured. Moreover, the method 200 is not limited to the particularorder illustrated here.

At step 210, patient data can be received into the patient database 110in which the patient data at least includes a diagnosis of the patient.At step 212, one or more treatment protocols for the patient can beprovided for selection by a treating provider in which the treatmentprotocols are pre-approved for the patient diagnosis. A specific exampleof a patient having stage 2 breast cancer will be presented here,although it is understood that the method 200 is in no way limited tothis particular illustration.

The treating provider, as described earlier, can enter the patient'sdata in the patient database 110, and in this instance, the diagnosis isstage 2 breast cancer. The treatment protocol database 120 can receivethis information and can cause one or more pre-approved treatmentprotocols to be displayed to the treatment provider. Here, multipletreatment protocols for treating this particular form of cancer and itsprogression can be displayed. The treatment protocols can bepre-approved treatment plans for each disease or medical condition forwhich they are designed. A “pre-approved treatment protocol” is aguideline or set of guidelines or strategy for treating a particulardisease or medical condition that has been designated as an acceptableform of treatment for such disease or medical condition by anorganization that is familiar with the disease or medical condition atissue. As an example, in this case, the treatment protocols can all begeared towards treating stage 2 breast cancer, and the protocols can bebased on the guidelines of the National Comprehensive Cancer Network orsome other suitable organization that specializes in cancer research.

Referring back to the method 200, a selection of a treatment protocol bya treating provider can be analyzed, as shown at step 214, and at step216, an authorization of the selected treatment protocol based onpredefined criteria can be generated. In one arrangement, generating theauthorization can be automatically performed without any peer review ifthe selected treatment protocol meets the predefined criteria, as shownat step 218.

In an alternative arrangement, if the selected protocol does not meetthe predefined criteria, then the authorization may be generatedfollowing peer review, as shown at step 220. In this alternativearrangement, a relationship can be established between the treatingprovider and a treatment reviewer to determine whether to generate theauthorization, as shown at step 222. Moreover, at step 224, as part ofthe peer review, input can be sought from one or more authorized agentsfollowing the establishment of the relationship between the treatingprovider and the treatment reviewer. In either arrangement, at step 226,the treating provider can be informed of a status of the authorization,and a primary care agent can be informed of the selected treatmentprotocol and any details of a peer review if such a review wasconducted, as shown at step 228. Examples of these processes will now beprovided.

Once the treating provider selects a pre-approved treatment protocol,the protocol approval module 130 can analyze the selection in view ofcertain predefined criteria. The predefined criteria can be any suitablenumber of factors that can indicate the effectiveness of a treatmentprotocol, such as toxicity, ability to improve a patient's condition andoverall cost. For example, the treating provider may select a treatmentprotocol that includes the use of one or more drugs for treating breastcancer that are within acceptable cost ranges but that are just aseffective as other, more expensive treatments. In addition, the selectedprotocol may be appropriate for use by the particular patient inquestion, as determined by the protocol approval module 130. Such aselection can be automatically approved or authorized by the protocolapproval module 130, and the module 130 may signal the treatingprovider, through any suitable means, of the status of theauthorization.

On the other hand, however, the treating provider may select a treatmentprotocol that, while pre-approved for treatment of breast cancer, is farmore expensive than other available treatment protocols but that doesnot present an increase in utility or effectiveness. Further, theselected treatment protocol may be more toxic for the particular patientin question when compared to other treatment protocols. In thesesituations, the protocol approval module 130 may flag the selectedtreatment protocol and designate it for peer review, forwarding therelevant information to the peer review workstation 140.

As another example, the treating provider may select a treatmentprotocol that—while pre-approved for treatment of breast cancer—may beless effective than other treatment protocols. This exemplary selectedtreatment protocol, however, may also have fewer adverse effects, thuslimiting its utility to special circumstances. Special circumstances mayinclude, but are not limited to, pre-existing medical conditions,patient age, and previous treatments. In these situations, the protocolapproval module 130 may flag the selected treatment protocol anddesignate it for peer review, irrespective of the cost of the protocol,forwarding the relevant information to the peer review workstation 140.

The treatment reviewer can then analyze the selected treatment protocoland the patient data to determine whether to approve or authorize theselected protocol. The term “treatment reviewer” is defined as anyentity, including a human being or a machine, capable of conducting areview of patient data and selected treatment protocols to determinewhether a treatment protocol that is more appropriate than the selectedtreatment protocol based on various factors, such as cost or efficacy,is available for the patient. As an example, the treatment reviewer canbe a specialist in the field associated with the diagnosis of thepatient and the provided treatment protocols. In the example describedthus far, the treatment reviewer may be an experienced oncologist. Inaddition, the phrase “peer review” or “peer review process” is definedas any procedure to be conducted by a treatment reviewer to determinewhether a more appropriate treatment protocol is available.

As part of the review, the treatment reviewer may contact the treatingprovider to discuss or otherwise acquire more information from thetreating provider. Alternatively, the protocol approval module 130 maygenerate a signal that causes a notice to be sent to the treatingprovider asking the treating provider to contact the treatment reviewer.This notice can include any suitable amount of information to enable thetreating provider to contact the treatment reviewer and may or may notgive an indication as to why the selected treatment protocol has beendesignated for peer review.

Once the relationship is established, the treating provider may providean explanation as to why the selected treatment protocol is the properprotocol to employ for the patient. The treatment reviewer may alsoexplain why an unselected treatment protocol is more appropriate foruse, based on, for example, its lower cost or increased effectiveness.This exchange of information can occur through any suitable means,whether electronic (for example, phone, e-mail, on-line meeting) orin-person meetings.

As an example, the treatment reviewer may suggest a protocol treatmentthat relies on less expensive drugs that would be just as effective intreating the patient, and the treating provider may agree with thesuggestion and select the suggested protocol, thereby lowering theamount of money needed for the patient's healthcare. The treatmentreviewer or some other suitable entity can then approve or authorize thenew selected treatment protocol and can inform the treating provider ofthe status of the authorization.

Conversely, the treating provider may explain to the treatment reviewerthat the treatment protocol suggested by the treatment reviewer,although a pre-approved protocol, includes a regimen that is notsuitable for treating the patient. For example, some of the drugs of thesuggested treatment protocol may be toxic to the patient, or thetreating provider may have evidence, based on the patient's healthhistory, that demonstrates that the suggested treatment protocol willnot be as effective in treating the patient. The treatment reviewer mayagree with the explanation provided by the treating provider and mayapprove the originally selected treatment protocol, even if it is moreexpensive than some of the other pre-approved but unselected treatmentprotocols. The treating provider can then be informed of the status ofthe authorization.

In one arrangement, if the treatment reviewer does not accept thetreating provider's rationale, the treatment reviewer may seek inputfrom one or more authorized agents, similar to an appellate process. Theterm “authorized agent” is defined as any entity, including a humanbeing or a machine, other than the treatment reviewer capable ofconducting a review of patient data and selected treatment protocols todetermine whether the protocol treatment selected by the treatingprovider and the justification provided by the treating provider forsuch selection warrants approval or authorization over the objectionsraised by the treatment reviewer. For example, in the case where thepatient has breast cancer, the authorized agent may be anotheroncologist who has several years of experience in dealing with treatmentof patients afflicted with the cancer. This appellate process mayinclude the treatment reviewer receiving input from a team of authorizedagents, if so desired.

If the authorized agent agrees with the treatment reviewer, thetreatment reviewer may maintain the objection and may not authorize ormay not recommend the authorization of the selected treatment protocol.If the authorized agent, however, disagrees with the treatment reviewer,the treatment reviewer may remove the objection and authorize theselected treatment protocol. In either case, the treating provider canbe informed of the status of the authorization.

In addition to providing notice to the treating provider concerning thestatus of the authorization of the selected protocol, such informationmay also be provided to other interested parties. For example, a primarycare agent responsible for managing the healthcare of the patient mayreceive a notice of the selected treatment protocol and any details of apeer review if such a review was conducted. This notice may include theauthorization or the declination of such authorization by the treatmentreviewer. The primary care agent can be, for example, a primary carephysician employed by a health insurance company or a government agencywho is responsible for approving payment of healthcare costs of thepatient by the health insurance company or government agency. Afterreceiving this information, the primary care agent may make an informeddecision as to whether to authorize payment for the selected treatmentprotocol.

As previously noted, current fee structures that are in place in thehealthcare industry may cause physicians to favor more expensive drugsover those that are cheaper yet that are just as effective. For example,continuing with the breast cancer example, assume that two of the mosteffective treatments for stage 2 of this cancer are Treatment A andTreatment B. Therapeutically, these chemotherapeutic protocols areequivalent. Treatment A, however, costs about $890 for treatment, whileTreatment B is about $27,700 for treatment. The profit for a treatingphysician for use of Treatment A is about $44.50 over eight months;however, for Treatment B, the physician will realize about $1,385 inprofit for the same time period. Clearly, there is an incentive for thetreating doctor to choose the more expensive treatment, even though suchtreatment is no more effective than the more moderately priced one.

Referring once again to the method 200 of FIG. 2, at step 230, it can bedetermined whether to apply a normalization fee for the selectedtreatment protocol, and this normalization fee can be applied toincrease the amount of profit that the treating provider would realizefor the selected treatment protocol. The term “normalization fee” meansany adjustment of compensation to a treating provider that wouldincrease the incentive for the treating provider to select a particulartreatment protocol. As an example, the normalization fee can be a flatrate fee that can be paid to the treating provider per treatment sessionfor the patient.

To demonstrate the use of a normalization fee, a discussion will bepresented that makes use of the two treatments described above. Forexample, a normalization fee of approximately $150 per treatment sessionfor the patient can be applied to the treatment protocol associated withTreatment A for stage 2 breast cancer. Assuming monthly treatments forsix months, this would generate about $900 in profit for the treatingprovider. The treating provider would also receive a small percentage,such as five percent, of the overall cost of the treatment, which isconsistent with standard practice. In this case, this amount would befive percent of $890, or $44.50. As a result, the total profit for thetreating provider would be slightly under $950.

In comparison, the more expensive Treatment B would result in a totalprofit of $1,385, and no normalization fee would be applied. Because thetreating provider would receive a higher profit than would normally berealized for the much cheaper and equally therapeutic Treatment A, therewould be less incentive for the treating provider to select the vastlymore expensive Treatment B. In summary, the normalization fee can bedesigned to “level the playing field” so that the profit from lessexpensive protocols can be approximately equal to the profit from moreexpensive protocols. It is understood that the above description ismerely exemplary in nature, and the subject matter described herein canbe applied to various other treatment protocols and numerical values.

This normalization fee can be selectively applied to treatment protocolsbased on certain criteria, such as costs and effectiveness. In theexample above, the normalization fee can be applied to Treatment A inview of its relatively limited expense but not to Treatment B based onits high cost. As another example, there may be a case where twopre-approved treatment protocols are roughly the same cost, but one maybe considered less toxic or more effective in treating patients. Ifdesired, a normalization fee may be applied to the more effectiveprotocol treatment to increase the chances of its selection.Additionally, there may be some cases where no normalization fee will beapplied to any pre-approved treatment protocols for a certain disease ormedical condition. For instance, all the protocol treatmentspre-approved for a certain cancer may be relatively expensive, withlittle or insignificant difference in their prices. Because the profitpotential for each of these treatment protocols would be similar, it maynot be necessary to attempt to adjust the incentive for the treatingprovider to select a particular treatment protocol.

Referring back to the method 200, at step 232, the number of treatmentprotocols available for selection by the treating provider may beadjusted if an initial selected protocol was unsuccessful in treatingthe patient. For example, considering the exemplary patient diagnosedwith stage 2 breast cancer, assume the patient completed an initialtreatment that was unsuccessful. By unsuccessful, the patient may nothave shown any improvement in her condition or may have relapsed afterthe initial treatment. At this point, the treating provider may wish tobegin another treatment protocol. When doing so, the number of treatmentprotocols available for selection in the treatment protocol database 120may be adjusted. In one particular example, the initially selectedtreatment protocol and equivalent treatment protocols may be removedfrom the list of available treatment protocols, thereby reducing thenumber of available protocols, because these protocols have been shownto be ineffective. That is, the system 100 can automatically eliminatetreatment protocols that may not be of value based on the patient'streatment history. This adjustment in the number of available protocolscan be repeated if the patient continues to show no improvement orrelapses again.

Embodiments herein can take the form of hardware and/or softwareelements. In one embodiment, the subject matter is implemented insoftware, which includes but is not limited to firmware, residentsoftware, microcode, and the like. Furthermore, the subject matter cantake the form of a computer program product accessible from acomputer-usable or computer-readable medium providing program code foruse by or in connection with a computer or any instruction executionsystem. The computer program product can include all the featuresenabling the implementation of the methods described herein, and whichwhen loaded in a computer system is able to carry out these methods.Computer program in the present context means any expression, in anylanguage, code or notation, of a set of instructions intended to cause asystem having an information processing capability to perform aparticular function either directly or after either or both of thefollowing: a) conversion to another language, code or notation; b)reproduction in a different material form.

For the purposes of this description, a computer-usable or computerreadable medium can be any apparatus that can contain, store,communicate, propagate, or transport the program for use by or inconnection with the instruction execution system, apparatus, or device.The medium can be an electronic, magnetic, optical, electromagnetic,infrared, or semiconductor system (or apparatus or device) or apropagation medium. Examples of a computer-readable medium include asemiconductor or solid state memory, magnetic tape, a removable computerdiskette, a random access memory (RAM), a read-only memory (ROM), arigid magnetic disk and an optical disk. Current examples of opticaldisks include compact disk-read only memory (CD-ROM), compactdisk-read/write (CD-R/W) and DVD.

A data processing system suitable for storing and/or executing programcode can include at least one processor coupled directly or indirectlyto memory elements through a system bus. The memory elements can includelocal memory employed during actual execution of the program code, bulkstorage, and cache memories which provide temporary storage of at leastsome program code in order to reduce the number of times code must beretrieved from bulk storage during execution. Input/output or I/Odevices (including but not limited to keyboards, displays, pointingdevices, etc.) can be coupled to the system either directly or throughintervening I/O controllers. Network adapters may also be coupled to thesystem to enable the data processing system to become coupled to otherdata processing systems or remote printers or storage devices throughintervening private or public networks. Modems, cable modem and Ethernetcards are just a few of the currently available types of networkadapters.

The foregoing description of embodiments has been presented for thepurposes of illustration. The description is not intended to limit theinvention to the precise forms disclosed. Indeed, modifications andvariations will be readily apparent from the foregoing description.Accordingly, it is intended that the scope of the claims not be limitedby the detailed description provided herein.

What is claimed is:
 1. A method of medical treatment review, comprising:receiving patient data into a patient database, wherein the patient dataat least includes a diagnosis of the patient; providing one or moretreatment protocols for the patient for selection by a treatingprovider, wherein the treatment protocols are pre-approved for thepatient diagnosis; analyzing a selection of a treatment protocol by thetreating provider; and generating an authorization of the selectedtreatment protocol based on predefined criteria.
 2. The method of claim1, wherein generating an authorization of the selected treatmentprotocol comprises generating the authorization without any peer reviewif the selected protocol meets the predefined criteria or generating theauthorization following peer review if the selected protocol does notmeet the predefined criteria.
 3. The method of claim 2, wherein the peerreview comprises establishing a relationship between the treatingprovider and a treatment reviewer to determine whether to generate anauthorization for the selected treatment protocol.
 4. The method ofclaim 3, wherein the treatment reviewer is a specialist in the fieldassociated with the diagnosis of the patient and the provided treatmentprotocols.
 5. The method according to claim 4, wherein the peer reviewfurther comprises seeking input from an authorized agent following theestablishment of the relationship between the treating provider and thetreatment reviewer.
 6. The method according to claim 5, furthercomprising the steps of: informing the treating provider of a status ofthe authorization; and informing a primary care agent of the selectedtreatment protocol and any details of a peer review if such a review wasconducted.
 7. The method according to claim 1, further comprisingdetermining whether to apply a normalization fee for the selectedtreatment protocol.
 8. The method according to claim 7, wherein thenormalization fee is applied to increase the amount of profit that thetreating provider would realize for the selected treatment protocol. 9.The method according to claim 7, wherein the normalization fee is a flatrate fee to be paid to the treating provider per treatment session forthe patient.
 10. The method according to claim 1, further comprisingadjusting the number of treatment protocols available for selection bythe treating provider if an initial selected treatment protocol wasunsuccessful in treating the patient.
 11. The method according to claim10, wherein adjusting the number of treatment protocols available forselection by the treating provider comprises eliminating from selectionthe initial selected treatment protocol that was unsuccessful intreating the patient and any equivalent treatment protocols. 12-15.(canceled)
 16. A method of treatment review by a treatment reviewer,comprising: receiving patient data and a selected treatment protocol fora patient from a treating provider, wherein the selected treatmentprotocol is part of an approved listing of treatment protocols;conducting a peer review of the patient data and the selected treatmentprotocol by a treatment reviewer to determine whether to approve theselected protocol in view of other unselected treatment protocols thatare part of the approved listing of treatment protocols, whereinconducting the peer review at least includes performing an exchange ofinformation between the treatment reviewer and the treating provider;and providing results of the peer review to the treating provider. 17.The method according to claim 16, wherein the peer review is conductedonly if the selected treatment protocol is not automatically approvedbased on certain predefined criteria.
 18. The method according to claim16, further comprising informing a primary care agent of the selectedtreatment protocol and any details of the peer review.
 19. The methodaccording to claim 16, further comprising selectively conducting anappellate review of the peer review if the treating provider maintainsthe selection of the selected treatment protocol.
 20. A method ofselecting a treatment protocol by a treating provider, comprising:entering patient data into a patient database; selecting a treatmentprotocol from a list of pre-approved treatment protocols, wherein atreatment protocol is pre-approved based on the patient data; receivingan authorization for the selected treatment protocol, wherein theauthorization is automatically generated or generated following a peerreview that determines that other unselected treatment protocols areunsuitable for the patient.
 21. The method according to claim 20,further comprising receiving a normalization fee for the selectedtreatment protocol based on predefined criteria, wherein thenormalization fee is a flat rate that is received for treatment sessionsfor the patient and is higher than the amount of profit that thetreating provider would receive based on a percentage fee of theselected treatment protocol.
 22. The method according 20, wherein thepatient is an existing patient and the number of treatment protocolsthat are available for selection is different than the number oftreatment protocols that were available for selection at the initialentry of the patient data.